HEART MATTERS – The new 40s Syndrome - Aventure Health & Fitness - Volume 12 / Issue 1 / January 2022

JGI JAIN -  Aventure Health & Fitness - Volume 12 / Issue 1 / January 2022

HEART MATTERS – The new 40s Syndrome

“We first make our habits, then our habits make us.” – John Dryden, an English poet.

40s is the new 30s – popular headline nowadays! The 40s generation is motivated to look young, imitate the younger to create an illusion of sorts. One aspect is looking younger, while the other is about ‘acting’ young. The modifications to the body in terms of the physique, the ‘blacking’ of the grey, anti-wrinkle escapades among others to appear young is pure illusory effect. Also, there is a blind copy of western culture more so in the work environment to ape their work ethic, sans the framework that the western professionals enjoy as a much-needed cushion to work in a professional environment. Are there any repercussions that can harm the naturally ageing body? Prasanna S. Harihar discuss here in this article.

Habits Maketh an Individual!

Habits die hard. They push us into a safety zone. Sometimes, we even end up a slave to them. It is only prudent that a poor habit grows to diminish into extinction.

Going by this axiom, habits mould an individual’s life. First it is the thinking that is influenced into a pattern of behaviour. Then the pleasure derived from it propels us to repeatedly pursue for continuous satisfaction. Next what sets in is a safety net that mandates us to make that chore a pleasurable habit and later getting rid of the same becomes impossible.

For example, we are aware of the all-pervasive drug problem in society. An opioid overdose can cause a cardiac arrest. We have heard of a few cases in the 40s generation who have taken to cycling or marathon running and a few other extreme sports. While a healthy appetite for challenges is good and the associated daredevilry is appreciated, one has to ensure that fitness review and a green signal is mandatory from a medical practitioner. In its absence, the interest area grows to become a habit and then a compulsive obsession which may lead to extreme health conditions.

The mantra is – exercise restraint over one’s habits and resist the status quo to explore beyond the safety net.

 

Young Succumb to Heart Attacks

Heart attacks were primarily a problem faced by older adults. In an advanced country like USA, it was rare for anyone younger than 40 to suffer a heart attack but not so today with almost 1 in 5. Closer home, as per the Indian Heart Association, heart disease strikes Indians at an earlier age (almost 33 per cent earlier) than other demographics, often without prior warning. Reports suggest that CVDs – Cardiovascular diseases strike Indians a decade earlier than the western population.

D r. Sathyanath , a leading U K physician comments: “The single most important risk factor for coronary heart disease is genetic, especially in the young where Hypertrophic Cardiomyopathy (a condition in which the heart muscles become abnormally thick making it harder to pump blood) can cause sudden death in the 40s. South Asians are particularly prone to coronary artery disease. The so-called modifiable risk factors are smoking, obesity, especially truncal obesity, diabetes and hypertension.”

In recent times, India has witnessed rapid urbanization, globalization, increased Young Succumb to Heart Attacks sedentary lifestyles, unhealthy diets, overweight, tobacco usage and increased life expectancy. As per a 2020 study, tobacco smoking in males (23.6 per cent) is higher than the global prevalence (22 Per cent). Obesity is increasingly in adult urban population, and abdominal obesity a major cause for concern. One in every four individuals older than 18 years has an increased blood pressure level. India has catapulted to be the diabetes capital of the world.

A healthy balanced diet and regular physical activity is a behavioural change to be initiated to reduce this burden. What gives the medical community the jitters is when individuals, reportedly super-fit, with a good exercise and diet regimen develop strange but overlooked symptoms and die a sudden death.

The 40s generation in India is affected for two reasons work ethic and personal image. Both are expectations related to pressure from the surrounding as well as from the self. We don’t find these in older generations for obvious reasons.

In the former, the Indian workplace is today a 24 x 7 operating unit catering to the far east as well as the west, which comes with challenges and opportunities. In the latter, the consumerist culture of the West and India depict the ageing population as still looking fabulous and healthy which our Indian society accepted and adopted in its full steam – to flaunt a toned body we started to expend effort to look much younger than our age.

Work life in India due to growing globalization has created both a positive and a negative influence on the 40s to 50s generation. Dr. Anil Kumar, Head, Dept. of Medicine of a leading teaching hospital reviews case histories of many patients who come with some symptoms. “In young heart attacks, it is genes, genes and genes all the way. Steroids, drugs, obesity surgery don’t play a major role in heart attack causation. There are reversible and irreversible factors. Irreversible are family history, male gender, Asian origin, etc. Reversible are lifestyle factors such as hypertension, smoking, sedentary lifestyle, excessive alcohol consumption, etc.”

Dr. Charitha at a premier medical educational institution remarked: “Heart attack sometimes is a result of a single cause but most of the time it’s the end result of multiple disease processes. While we have accepted that heart attacks are more common in the 65+ age groups, today, we are hearing more instances of individuals in 30s and 40s who are victims. As far as I know, researchers haven’t been able to pin-point exactly what the cause is, there are various ‘non-communicable causes’ being listed as the reason for increase in heart attacks.”

Impact of Western Work Ethic on Indian Ethos

Expectations imposed by MNCs include unrealistic professionalism, extended hours of work to overlap their country business hours, aggressive deadlines, working with a global workforce and higher productivity. Juxtapose this, with the fact that unlike many developed countries, in our country there is paucity of a work-ethic framework leave alone public health infrastructure and initiatives to raise awareness about heart health. To date, only a few healthcare providers in India routinely screen for heart disease risk factors. Combined with lack of education and awareness among the young and along with an insouciant approach, the problem stands magnified.

The newfound opportunity to quickly move up the corporate ladder exposes one to extended work hours, unhealthy eating habits, acute shortage of sleep, and quick fix to problems in the form of increased uptake of medicines which does not give the body the space to naturally cure – all of which results in high levels of stress.

Look better, younger! At what cost?

Western consumerism induced the need to look fabulous, not just good. The first target was our movie stars who to cope with the pressure to look a certain way succumbed easily. The need to imitate celebrities became compelling for the average Indian and many went a little too far. Gymnasiums and beauty parlours popped up everywhere giving access to the young to look like their celebrity idols.

Body shaming took to mainstream, and many became image conscious. A 6-pack torso became a necessity, and the indiscriminate usage of anabolic steroids and protein powder became a habit. A spate of surgeries like bariatric, liposuction, hair transplantation, rhinoplasty, etc. are being used to look good and fine. On their own these surgeries when done properly are harmless, but then there could be side-effects even though the probability is lower. Any procedure or surgery creates more stress for living up to society’s as well as one’s own self-image.

Dr. Charitha adds, “The amount of stress an individual is subjected to is enormous these days. There is tension regarding work-life balance, financial problems, domestic and family problems, the self-induced reason to look a particular way, dress up a particular way, to meet expectations, to meet project deadlines, and many more. What one fails to realise is its impact on the mind and body. The body prepares itself to the onset of danger and tries to fight the situation with natural immunity. But continuous stress harms the body.”

Gymnasiums and trainers resort to unscientific methods to help their members realize their objectives. Upfront these places promise a certain amount of weight reduction. The unscientific means in terms of excessive and high intensity workouts increase the risk factor. Some of these gymnasiums are not certified by a central body, in some cases the trainers have not undergone formal training and obtained certifications, many of them do not have doctors available either on premises or on-call, all of which has led to an increase in the risks associated without a deeper understanding of the aftermath.

Dr. Sathyanath added, “Excessive physical exercise has been linked to sudden death, although it has to be stressed that it is very rare and usually these people have some underlying risk factors which may not have been identified. Indeed, their first presentation may be sudden death! Often these are the people who are prone to abusing anabolic steroids which may increase the risk of coronary artery disease.”

Lack of quick access to healthcare in an emergency situation, exposure to toxins and radiation due to unhealthy work environments, increased dining out and irrational consumption of junk food which are high in trans-fat, decreased consumption of fresh fruits and vegetables, acute lack of sleep due to change in work situations particularly in this pandemic-induced work-from home environment, and a plethora of other factors create a perfect storm for an increased incidence of heart-attacks.

The 40s and the 50s are the age-group highly affected for they look at these productive and growing years as the best time to elevate their standard of living.

Methods to develop rural reach with necessary infrastructure will prove to be beneficial with an increased imperative. Joining hands with corporates will provide the necessary edge to educate employees and bring them on-board for a massive education program that can help our vast population. Public-private-corporate-educational institution-hospital collaboration can effect a positive change to help reduce the burden that we carry as a country today.

As Dr. Sathyanath has highlighted earlier, the underlying factors still drive the outcome but there are many contributing factors. If driven to excessiveness, the results can be disastrous. We know that workouts are good, but it is recommended to obtain a prior doctor’s opinion. Excessive workout with irrational intake of protein powder and steroid usage can only hamper the progress in the long-run. Any sudden death even though in very small numbers, is still an event that stands out in the data presented as outliers.

Summary

Heart health matters the most for an active life. Thus, to protect the heart health from exposing it to any extreme conditions an individual needs to do a conscious living.

Sticking to the basics in terms of what we need but accessing a few of the wants is still realistic. When the desires takes over our thinking that is when we run into a gamut of problems. Work has to be balanced with good life; looking good has to be balanced with prudent living.

We need to get into the practise of proactive health check-ups at a younger age. We need to commit ourselves to staying compliant with prescription medication if there are a few anomalies reported in our health. We need to stay healthy with good food and exercise regimen, rather than excessive unhealthy bad food habits. We also need to gracefully accept the changes in our body as we age.

Genes that we have inherited largely decide our health. But the many factors that have been discussed here which are lifestyle and mindset aspects tend to take its toll over a period of time. The rationale is any of those influencing factors can trigger certain events due to underlying genetic predispositions. In the end, the matter of the heart is worth its weight in gold and let every hour be the golden hour to alleviate the heart problems – the Art of the Heart is the most precious and cherished indeed!